前前脑-丘脑环路在全脑缺血期间低温诱导的脑保护中的作用  

Role of anterior forbrain thalamic loop in hypothermia induced brain protection during global cerebral ischemia

作　　者：王小华[1,2] 聂彬彬 李燕虹[1,2] 赵菁 张婷[1,2] 王天龙 姜伟 WANG Xiaohua;NIE Bingbing;LI Yanhong(Department of Anesthesiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053 [2]国家老年疾病临床研究中心,北京100053 [3]中国科学院高能物理研究所放射技术与设备北京工程研究中心,北京100049 [4]中国科学院大学核科学技术学院,北京100049 [5]首都医科大学宣武医院普外科,北京100053 [6]解放军总医院第三医学中心麻醉科,北京100039

出　　处：《中风与神经疾病杂志》2020年第12期1065-1069,共5页Journal of Apoplexy and Nervous Diseases

摘　　要：目的心脏骤停是全世界常见的主要死因。低温是预防心脏骤停后全脑缺血(GI)的重要保护方法。然而,低温在大脑不同区域的作用的机制尚未完全阐明。方法在本研究中,我们利用正电子发射断层扫描(PET)和磁共振成像(MRI)研究了大鼠低温GI和常温GI模型中,脑内代谢变化节点。为了识别潜在低温保护的脑环路,基于Voxel分析代谢节点,利用扩散张量成像(DTI)的分数各向异性构建了低温GI和常温GI的白质网络,并对该通路上的核团进行了鉴定。结果基于PET体素的分析表明,低体温GI组大脑低代谢区信号明显缩小,而常温GI组低代谢区则明显扩大。低温选择性地保留了前前脑-丘脑环路,包括丘脑、前额叶皮质重要脑区和它们之间的联系,包括胼胝体和内囊之间的联系。结论在接受低温治疗的大鼠中,观察到前前脑-丘脑环路维持功能完整性。前前脑-丘脑环路在低温中相对保存,并在低温脑保护中发挥重要作用。Objective Cardiac arrest is a major cause of death worldwide.Hypothermia is an important protective method against global cerebral ischemia(GI)following cardiac arrest.However,the mechanisms of hypothermia underlying the changes in different regions and nodes of the brain have not been fully elucidated.Methods In this study,We investigated the metabolism of brain and its nodes in rat hypothermia GI and normothermia GI models using positron emission tomography(PET)and magnetic resonance imaging(MRI).Voxel-based analysis was used to assess the metabolic nodes.To identify the cerebral circuit of potential hypothermia protection,a white matter network of hypothermia GI and normothermia GI was constructed using fractional anisotropy from diffusion tensor imaging(DTI)and the nuclei on the pathway were also identified.Results The PET voxel-based analysis demonstrated that there was significant reduce hypometabolic region of the brain in the hypothermia GI group compared with that in the normothermia GI group.Hypothermia selectively preserved the mesocircuit including the thalamus,prefrontal cortex,and the connections between them,including those between the corpus callosum and internal capsule.Conclusion In rats that underwent hypothermia,the preserved functional integrity of the anterior forebrain mesocircuit.We provide evidence that the anterior forebrain mesocircuit is relatively preserved in hypothermia and has an important role in cerebral protection.

关 键 词：低温 前前脑丘脑环路 全脑缺血 心脏骤停 正电子发射断层扫描 磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]